Congenital Pseudoarthrosis of the Tibia

• the most common cause of anterolateral bowing.
• It is often accompanied by neurofibromatosis (50%-but only 10% of patients with neurofibromatosis have this disorder).
• Classification (Boyd) is based on bowing and the presence of cystic changes, sclerosis, or dysplasia and cystic changes are most common.

Tibial Pseudoarthrosis Treatment

• total contact brace to protect from fractures
• intramedullary fixation with excision of hamartomatous tissue, and autogenous bone grafting (osteosynthesis) for nonhealing fractures.
• Vascularized fibular graft or Ilizarov methods should be considered if bracing fails.
• Osteotomies and electrical stimulation alone are contraindicated.
• Amputation (Syme's) and prosthetic fitting are indicated after two or three failed surgical attempts.

Review Refernces

• Murray HH, CORR 1982;166:14
• Crossett LS, CORR 1989;245:16